RESUMEN
Abstract Objective To determine the modifiable risk factors associated with severity of plantar fasciitis and to formulate an objective scoring system for indexing plantar fasciitis in the non-athletic population. Methods This was a prospective observational study. The main outcome measure was the association of a modifiable risk factor, which was measured with the Pearson coefficient (R-value) and the level of significance, which was kept as p < 0.05. Result In a sample size of 50 patients, the body mass index (BMI) and ill-cushioned shoes were found to be significantly associated with pain in plantar fasciitis. All the other risk factors were either non-modifiable or had no significant association. Conclusion Based on available data and further interpretation, an index was be formulated, named as Ranjeet-Kunal Index for Scoring Plantar fasciitis (RKISP), which can be successfully used for not only grading plantar fasciitis but also prognosticating the conservative management of the same, thus deciding the modality of treatment.
Resumo Objetivo Determinar os fatores de risco modificáveis associados à gravidade da fasciíte plantar e formular um sistema objetivo de pontuação para indexação da doença na população não atlética. Métodos Estudo observacional prospectivo. A principal medida de desfecho foi a associação de um fator de risco modificável, mensurada pelo valor de R (coeficiente de Pearson) e pelo nível de significância de p < 0,05. Resultados Em uma amostra de 50 pacientes, o índice de massa corporal (IMC) e calçados com amortecimento inadequado foram associados de maneira significativa à dor na fasciíte plantar. Todos os demais fatores de risco eram não modificáveis ou não apresentaram associação significativa. Conclusão Com base nos dados à disposição e sua interpretação, um índice, denominado Índice de Ranjeet-Kunal de Pontuação da Fasciíte Plantar (RKISP, em inglês) , foi formulado e utilizado com sucesso não apenas na classificação da fasciíte plantar, mas também na determinação do prognóstico de seu tratamento conservativo, auxiliando a escolha da modalidade terapêutica.
Asunto(s)
Humanos , Factores de Riesgo , Fascitis Plantar , Dolor Crónico , Tratamiento ConservadorRESUMEN
Background: Lumbar spinal stenosis (LSS) is commonly seenin the elderly especially owing to the aging of the spine.Growing in the facet joints, ligamentum flavum hypertrophy,disc degeneration, and osteophytes cause the spinal canal toconstrict and accordingly result in spinal cord and nerve rootcompression. If conservative treatments fail, surgicalintervention will be considered as the next treatment. Surgicaldecompression for LSS is indicated in a patient with intractablepain, neurogenic claudication, and motor weakness,accompanied by compromised spinal canal. Laminectomy forLSS is considered the standard surgical option to which othertechniques are compared. Ascertaining superiority of adecompression technique necessitates establishing if anydifferences exist in the complication rates and the functionaland symptomatic outcomes.Aim of the Study: To evaluate functional outcome oflaminectomy and laminotomy for the surgical management oflumber spine stenosis.Materials and Methods: The present study was conducted inthe Department of Orthopaedics, NIIMS Medical College,Jaipur, Rajasthan, India. For the study, patients with confirmedLSS (both lateral and/or central) on MR imaging who had failedconservative management, were considered for operativemanagement. Patients with spondylolisthesis, or scoliosis andthose who had undergone fusion, discectomies or furtherrevisions were excluded from the study. Following exclusions,50 patients were enrolled; 30 underwent a laminectomy withoutfusion and 20 underwent either a bilateral or unilaterallaminotomy.Results: We observed that VAS pain score decreased 6weeks post operatively for patients who underwentlaminectomy and laminotomy, however there was slightincrease in the pain score at 1-year post operatively. Theresults on comparison were found to be statically significant.Conclusion: Within the limitations of the present study, it canbe concluded that both surgeries were equally effective inimproving pain and disability.